The overall objective of this proposal is to investigate the molecular mechanisms underlying the late phase of preconditioning (PC). We will attempt to develop a unifying pathogenic paradigm applicable both to ischemia-induced late PC and to NO donor-induced late PC. our fundamental hypothesis is that, in both cases, the central cellular adaptation is responsible for late PC is the transcriptional up- regulation of the iNOS gene. We propose that transcription of iNOS is mediated by the coordinated activation of NF-kappaB and other transcription factors, which is triggered by NC via a signal transduction cascade that includes PKC, tyrosine kinases, and IkappaB kinase (IKK). Two different forms of late PC (PC induced by ischemic stress and PC induced pharmacologically with NO releasing agents) will be systematically examined. Unequivocal evidence for or against the involvement of specific genes encoding transcription and signaling factors will be provided by the use of gene targeted and transgenic mice in a well-established murine model of late PC. A broad multi- disciplinary approach will be used that will combine diverse techniques (integrative physiology, molecular biology, protein chemistry, cell biology, gene targeting and transgenesis) and will integrate genetic information at the molecular level with physiological information at the whole animal level. The effects of PC upon NOS mRNA, protein, enzymatic activity, and cellular distribution will be systematically defined for all three isoforms (eNOS, iNOS, and nNOS), providing for the first time a thorough characterization of these changes in the mouse. The signaling mechanisms that control iNOS expression will be interrogated by determining the effect of pharmacologic inhibitors of NOS, PKC, tyrosine kinases, and NF-kappaB on infarct size and by correlating these effects with their effects on iNOS transcription. For the first time, the effect of PC on the phosphorylation activity of the IKK complex (which controls NF-kappaB) will be examined. The role of NF-kappaB in late PC will be conclusively established by targeted gene ablation of three specific NF- kappaB subunits (p50, Rel-B, c-rel) and by genetic blockade of the IKK/IkappaB/NF-kappaB signaling pathway. Two novel transdominant NF- kappaB mutants (IkappaBalpha/S32A, S36A and IKK-beta/k44A) will be used to determine the role of IKK and IkappaBalpha in iNOS up-regulation. The specific modulatory proteins that govern iNOS gene expression during late PC will be systematically identified by targeted genetic ablation of the transcription factors known to bind to the iNOS promoter (IRF-1, TNFalpha, STAT1, CREB, AP-1, IL-2, IL-6). This proposal should provide important new insights into the molecular mechanisms of late PC and into the role of NO and iNOS in cardiovascular pathophysiology in general Elucidation of the mechanism of late PC should facilitate the development of novel pharmacological and/or gene therapeutic strategies that duplicate its powerful cardioprotective effects.
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